Where Have All the Private Duty Nurses Gone?

I have a nurse friend who has an acquaintance who is terminally ill. The wife of the patient wants private-duty nurses around the clock for him in their home. The problem is that she can't find any nurses who want the job.

The wife called my friend figuring that, since she is a nurse, she’d know other nurses who would want the private duty job. The pay was $40 - 45 an hour, and the first nurses to respond to the job would have their pick of shifts.

My friend called several nurses and couldn't get one taker. Neither of us were sure why, so I did a little searching and a little surmising.

First of all, I think the term “private duty” has sort of been usurped by home care nurses.

There are a lot of nurses visiting patients at home and giving care there, although these nurses usually don’t stay for eight hours. So, while it’s not quite the same as private duty, home care is similar. Also, years ago when private duty was more prevalent, there were few ICUs, so if patients wanted that one-to-one ratio, they had to hire a private-duty nurse. Today, if patients need one-to-one, they are placed into intensive care, where the level of technology is high and demands the skills of full-time ICU nurses.

To tell the truth, I hadn’t thought about private duty as a job option for years. The position just seems to have dropped from my employment radar screen. The last time I actually spoke to a private duty nurse was on a trip to Turkey six years ago. In our group of 11, there was a wealthy New York socialite in her early 90s who had a private-duty nurse who accompanied her on trips all over the world. The socialite had early-to-mid-stage dementia, and her conservator had hired this private-duty nurse to accompany this wealthy woman her on worldwide, month-long trips, which she took four times a year.

Although private-duty nurses almost seem like a thing of the past, there still are opportunities for those who want to pursue this type of employment, says Janet Haggerty Davis, RN, C, president of Advanced Practice Associates, a health care information consulting firm. In a piece she wrote recently for a trade publication, Haggerty said: “What is today’s fastest growing job category? Home care services, according to the U.S. Department of Labor. Reasons for the increasing demand… include an expanding older population with ready, disposable income; the dramatic longevity of children with chronic and debilitating health conditions; and the continued shift of health care delivery to the home setting.”

Have you ever done private duty nursing? If so, what was your experience?

Have you ever considered doing private duty?

What do you consider the best and worst of private duty nursing?

Tell us what you think.